Glossary of Culture-Bound Syndromes:

This glossary lists most of the culture-bound syndromes found in
the literature, although it is by no means exhaustive. Syndromes
are listed alphabetically in two sections: actual culture-bound syndromes vs. culture-specific idioms of disease (see the introductory essay for a brief description
of the differences.) The major geographical or cultural locale for
each syndrome is given, along with a brief description and a listing
of synonyms or similar syndromes in other cultural regions. For
syndromes (e.g., koro) which have a similar presentation in
many cultures, only one or two of the best-documented variants have
a description.

The following list is adapted in part from lists of culture-bound
syndromes given in DSM-IV (pp. 845-849) and in Kaplan and
Sadock's Synopsis of Psychiatry (pp. 190-191, 493-494). Simons
& Hughes (1985: 475-505) give a much more extensive listing of
culture-bound syndromes; however, their descriptors are not always
specific enough for inclusion here.

At present, descriptions in this list are more complete for
syndromes of East Asia, Southeast Asia, and South Asia, which are my
areas of interest.

Psychiatric syndromes which are endemic to particular
cultures:

amok or mata elap: (Malaysia) a dissociative
episode characterized by a period of brooding followed by an
outburst of violent, aggressive, or homicidal behavior directed at
people and objects. The episode tends to be precipitated by a
perceived insult or slight and seems to be prevalent only among
males. The episode is often accompanied by persecutory ideas,
automatism, amnesia for the period of the episode, exhaustion, and a
return to premorbid state following the episode. Some instances of
amok may occur during a brief psychotic episode or constitute the
onset or exacerbation of a chronic psychotic process.
Similar to cafard or cathard (Polynesia), mal
de pelea (Puerto Rico), iich'aa (Navaho), and syndromes
found in Laos, Papua New Guinea, and the Philippines. Similar also
to the nascent American folk-category of going postal.

anorexia mirabilis or holy anorexia: (medieval
Europe): severe restriction of food intake, associated with
experience of religious devotion. Often not considered pathological
within the culture. The terms are used by historians, and are not
emic.

anorexia nervosa (North America, Western Europe): severe
restriction of food intake, associated with morbid fear of obesity.
Other methods may also be used to lose weight, including excessive
exercise. May overlap with symptoms of bulimia nervosa.

boufée deliriante: (West Africa and Haiti) sudden
outburst of agitated and aggressive behavior, marked confusion, and
psychomotor excitement. It may sometimes be accompanied by visual
and auditory hallucinations or paranoid ideation.
Similar to DSM-IV brief psychotic disorder.

brain fag or brain fog: (West Africa) a condition
experience by primarily male high school or university students.
Symptoms include difficulties in concentrating, remembering, and
thinking. Students often state that their brains are "fatigued".
Additional symptoms center around the head and neck and include
pain, pressure, tightness, blurring of vision, heat, or burning.
"Brain tiredness" or fatigue from "too much thinking" is an idiom of
distress in many cultures.
May resemble anxiety, depressive, or somatoform disorders in
DSM-IV.

bulimia nervosa (North America, Western Europe): binge
eating followed by purging through self-induced vomiting, laxatives,
or diuretics; and morbid fear of obesity. May overlap with symptoms
of anorexia nervosa.

dhat: (India) semen-loss syndrome, characterized by
severe anxiety and hypochondriacal concerns with the discharge of
semen, whitish discoloration of the urine, and feelings of weakness
and exhaustion.
Similar to jiryan (India), sukra prameha (Sri
Lanka), and shenkui (China).

falling out or blacking out: (Southern U.S. and
Caribbean) episodes characterized by sudden collapse, either without
warning or preceded by feelings of dizziness or "swimming" in the
head. The individual's eyes are usually open, but the person claims
inability to see. The person usually hears and understands what is
occurring around him or her, but feels powerless to move.
May correspond to DSM-IV conversion disorder or
dissociative disorder

ghost sickness: (American Indian groups) preoccupation
with death and the deceased, sometimes associated with witchcraft.
Symptoms may include bad dreams, weakness, feelings of danger, loss
of appetite, fainting, dizziness, fear, anxiety, hallucinations,
loss of consciousness, confusion, feelings of futility, amd a sense
of suffocation.

hsieh-ping: (Taiwan) a brief trance state during which
one is possessed by an ancestral ghost, who often attempts to
communicate to other family members. Symptoms include tremor,
disorientation and delirium, and visual or auditory hallucinations.

hwa-byung or wool-hwa-bung: (Korea) "anger
syndrome". Symptoms are attributed to suppression of anger and
include insomnia, fatigue, panic, fear of impending death, dysphoric
affect, indigestion, anorexia, dyspnea, palpitations, generalized
aches and pains, and a feeling of a mass in the epigastrium.
See also bilis and colera, below.

koro: (Malaysia) an episode of sudden and intense anxiety
that the penis (or in the rare female cases, the vulva and nipples)
will recede into the body and possibly cause death. The syndrome
occasionally occurs in local epidemics.
This syndrome occurs throughout south and east Asia under
different names: suo yang (China); jinjinia bemar
(Assam); and rok-joo (Thailand). It has been identified in
isolated cases in the United States and Europe, as well as among
diasporic ethnic Chinese or Southeast Asians.

locura: (Latin America) a severe form of chronic
psychosis, attributed to an inherited vulnerability, the effect of
multiple life difficulties, or a combination of the two. Symptoms
include incoherence, agitation, auditory and visual hallucinations,
inability to follow rules of social interaction, unpredictability,
and possible violence.

pibloktoq or Arctic hysteria: (Greenland Eskimos)
an abrupt dissociative episode accompanied by extreme excitement of
up to 30 minutes' duration and frequently followed by convulsive
seizures and coma lasting up to 12 hours. The individual may be
withdrawn or mildly irritable for a period of hours or days before
the attack and will typically report complete amnesia for the
attack. During the attack, the individual may tear off his or her
clothing, break furniture, shout obscenities, eat feces, flee from
protective shelters, or perform other irrational or dangerous acts.
The syndrome is found throughout the arctic with local names.

Qi-gong Psychosis: (China) an acute,
time-limited episode characterized by dissociative, paranoid, or
other psychotic or nonpsychotic symptoms that occur after
participating in the Chinese folk health-enhancing practice of
qi-gong. Especially vulnerable are individuals who become overly
involved in the practice.

shenjian shuairuo: (Chinese) equivalent to now-defunct
diagnosis of "neurasthenia". Symptoms include physical and mental
fatigue, dizziness, headaches and other pains, difficulty
concentrating, sleep disturbance, and memory loss. Other symptoms
include gastrointestinal problems, sexual dysfunction, irritability,
excitability, and various signs suggesting disturbances of the
autonomic nervous system.
Many cases would be DSM-IV criteria for major depressive
disorder or an anxiety disorder.

Shenkui (Chinese): marked anxiety or panic symptoms with
accompanying somatic complaints for which no physical cause can be
demonstrated. Symptoms include dizziness, backache, fatiguability,
general weakness, insomnia, frequent dreams, and complaints of
sexual dysfunction (such as premature ejaculation and impotence).
Symptoms are attributed to excessive semen loss from frequent
intercourse, masturbation, nocturnal emission, or passing of "white
turbid urine" believed to contain semen. Excessive semen loss is
feared because it represents the loss of one's vital essence and can
thereby be life threatening.
Similar to dhat and jiryan (India); and sukra
prameha (Sri Lanka).

spell: (southern U.S.) a trance state in which
individuals "communicate" with deceased relatives or with spirits.
At times this is associated with brief periods of personality
change. Spells are not considered medical events in the folk
tradition, but may be misconstrued as psychotic episodes in a
clinical setting.

tabanka: (Trinidad) depression associated with a high
rate of suicide; seen in men abandoned by their wives.

taijin kyofusho: (Japan) a syndrome of intense fear that
one's body, body parts, or bodily functions are displeasing,
embarrassing, or offensive to other people in appearance, odor,
facial expressions, or movements.
Similar in some respects to DSM-IV social phobia, and
included in the official Japanese classification of mental
disorders.

windigo or witiko: (Algonkian Indians, NE US and
Eastern Canada) Not in DSM-IV. Famous syndrome of obsessive
cannibalism, now somewhat discredited. Wendigo was supposedly
brought about by consuming human flesh in famine situations.
Afterwards, the cannibal was supposed to be haunted by cravings for
human flesh and thoughts of killing and eating humans.
Excellent review of the windigo literature in Lou Marano.
"Windigo psychosis: the anatomy of an emic-etic confusion."
InThe Culture-Bound Syndromes. Ronald Simons and
Charles Hughes. (eds.) Boston, MA: D. Reidel Publishing Company.
1985.

zar: (Ethiopia, Somalia, Egypt, Sudan, Iran, and
elsewhere in North Africa and the Middle East) experience of spirit
possession. Symptoms may include dissociative episodes with
laughing, shouting, hitting the head against a wall, singing, or
weeping. Individuals may show apathy and withdrawal, refusing to
eat or carry out daily tasks, or may develop a long-term
relationship with the possessing spirit. Such behavior is not
necessarily considered pathological locally.
For an ethnographic description of similar possession, see
Vincent Crapanzano, Tuhami: portrait of a Moroccan.

Culture-specific idioms of distress and disease:

ataque de nervios: an idiom of distress principally
reported among Latinos from the Caribbean, but also among many Latin
American and Latin Mediterranean groups. Symptoms include
uncontrollable shouting, attacks of crying, trembling, heat in the
chest rising to the head, and verbal or physical aggression.
Ataques de nervios frequently occur as a result of a stressful
family event, especially the death of a relative, but also a divorce
or fight with a family member.

bilis and colera: part of a general Latin American
idiom of distress and explanation of physical or mental illness as a
result of extreme emotion, which upsets the humors (described in
terms of hot and cold.) Bilis and colera specifically implicate
anger in the cause of illness.

mal de ojo: (Spain and Latin America) the Spanish term
for the evil eye. Evil eye occurs as a common idiom of
disease, misfortune, and social disruption throughout the
Mediterranean, Latin American, and Muslim worlds.

nervios: (Latin America) Idiom of distress, refers to a
general state of vulnerability to stressful life experiences and to
a syndrome brought on by such stresses. Symptoms may be very broad,
but commonly include emotional distress, headaches, irritability,
stomach disturbances, sleep disturbances, nervousness, easy
tearfulness, inability to concentrate, tingling sensations, and
dizziness.
Similar to nevra (Greece).

rootwork: (Southern U.S. and Caribbean) a set of cultural
interpretations that explain illness as the result of hexing,
witchcraft, voodoo, or the influence of an evil person.
Similar to mal puesto or brujeria (Latin America).

susto: an idiom of distress principally reported among
Latinos in the U.S. and Latin America. Susto is an illness
attributed to a frightening event that causes the soul to leave the
body, leading to symptoms of unhappiness and sickness. Symptoms are
extremely variable and may occur months or years after the
supposedly precipitating event.
Alternate names include espanto, pasmo, tripa
ida, perdida del alma, and chibih.

This site was created on 21 Sep 1996. All original textual and photographic material on these pages is copyrighted 1996-2012 by Timothy M. Hall unless otherwise noted.